In this article - part 2 - I am giving my opinion about very young children going for many hours per day to nursery care – a very common solution to the ‘working Mom’ problem. Some are but babies and some attend every day for all day. Many young mothers make the decision to go out to work when their child is very young. To make a decision or choose to go in one direction rather than another requires information, without which mistakes can be made. Information is particularly important if that decision affects another vulnerable human being. No one is more vulnerable than a baby or very young child. The decisions made for and about them could have long lasting effects. Firstly, let me explain why I hold my views on this subject. When I was a junior doctor working in a children’s ward, I closely observed the children in the ward. Virtually all the children cried when they were initially left in the ward, unless they were, by that stage, too ill to respond. Through the ignorance of those years, the practice of parents leaving their children alone in the ward was thought ‘best for the child and the parent’ by those in high authority and visiting hours were allowed daily but were very short. But, though the children were very ill, after a short while they stopped crying. Fortunately that practice was eventually, after many years, changed and parents now stay fulltime with children in hospital in this country. Most people thought the children had ‘settled’. I didn’t, as it didn’t seem right. To me, observing closely, the children did not ‘look’ quite the same. The children in the ward became like little robots. To hear them cry was distressing; to see them when they stopped crying was confusing. It was as though I watched them ‘disappear’ in some way. I knew that, even with our dedicated care and treatment, which in those days was limited when compared to today’s wide range of drugs and advanced diagnostic techniques, these children were still in distress and often in pain. Yet, that ward had an eerie silence, until broken by the next patient to be admitted. Then soon, silence would reign again. Another event had happened a few years earlier, when I was 17 yrs of age. Something personal, that was to stick in my memory thereafter. My little brother, nearly 3 yrs old at the time, was admitted to hospital for a relatively minor operation. His physical pain was not great, though, in those days hospitalization remained until the last stitch was out and the wound fully healed. He was in hospital for about two weeks for what would now be a ‘day-case’. I spent endless hours at home with him and loved him deeply. I went to visit him and walked straight past him in the ward, until I heard his voice calling me. I was stunned. Totally shocked! How could I not recognise my little brother? The reason was that, though externally the same, to me he looked so different. I hadn’t been able to see him for about a week, but the happy, jolly child had disappeared and in his place was a white faced, frightened little boy with staring eyes whose ‘light had gone out’. He was able to recognise me, but showed no emotion. Even then, I asked myself, ‘What has happened?’ Once home he became a rather obsessive and anxious child, different from before his hospitalization. That episode was unfortunate, but it was not caused deliberately and it only lasted two weeks. But such was the effect of being isolated away from home and having a degree of pain - all in unfamiliar surroundings, even though seeing at least one of the family for one or two hours every day! I can define that point in time as where my interest in the psychological reactions to trauma began. I am writing my concerns about the effects - in the first two - three years of life, of nursery attendance and care, particularly in large nurseries, however kind the staff, and for many hours per day. I hear of babies of only a few weeks being taken to nursery at about 7 am so that the mum can catch the early train to work, and being picked up at around 7pm! I want you to do a little exercise. Imagine if you will, that suddenly you have been taken from your comfortable bed to a strange place and handed over to giants. You have lost your ‘adult’ abilities of understanding and perspective and are not able to recognise either faces or places. So, though you can see and hear you cannot make sense of anything around you. There is a lot of noise and someone is crying. Everything is strange and loud, and unfamiliarity brings fear. These giants and the place are so big! ‘What will they do to me? What will happen? Where am I?’ The person who handed you over, who you recognise and with whom you feel safe has gone. Will she/he come back? If she said so, you couldn’t make sense of her words. All you know is that you are alone and in a land of giants. Time passes and other giants appear. You cry. Occasionally someone, who you don’t know, picks you up. You hear others crying. Who are they and why are they crying? Are they being hurt? The fear of that unknown, makes you cry even more. What is going on? What can you do? The answer is nothing, you must just wait. Giants are talking but you cannot understand what they are saying. The nasty feeling in your stomach gets stronger. Where is the person that you know? Eventually, it is too much and tired with distress, you fall asleep. You awaken and the giants are still there and you cry again. They do not hurt you, but you are lost. Eventually, after what seems like for ever, the person you know and feel safe with comes and picks you up and takes you away from the unknown giants and back to the bed you left many hours ago. You feel safe at last. But, the next day – oh no, the same thing happens. And the next. And the next. And the next. Soon, you never feel safe or relaxed, even with the person you know. That feeling of safety has gone. Even with her, you are always waiting – waiting for her to go away again. You have no choice, day after day, but to face what is always a changing, fearful unknown. Some days you feel a pain, and cry even more. No one understands your pain. Sometimes you feel ill, so everything seems much worse, but no one knows how you feel. There is no point in wishing you were back in your own bed, no point wanting the person who left you there. You have no choice but to live each day as dictated by others. You have no voice, no say, and no rights. Translate that scenario into being a baby, a few months, or even weeks, old being taken to a large nursery for all day care. No matter how kind, how caring, how skilled the staff or how pleasant the surroundings, such very young children do not know where they are nor can they recognise faces or people. ‘Why does this matter?’ You may say. Maybe you like to think, that the child will get used to it eventually - ‘She/he appears to have settled now’ is what you hear and what you are told, just because there are no more tears. The question I ask is, ‘How?’ and I wonder, ‘At what cost?’ The children have to pay in terms of their emotional wellbeing and development and through no fault of their own. They had no choice. The theme continues in Part 3 and Part 4. Copyright©A Coatesworth 2010 Author of poetry books for children ‘Growing Up’, ‘Coping with Illness and Grief’
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Dr Audrey Coatesworth has retired from all clinical practice & now writes from her experience of 35 yrs in the psychiatric field of medical work. Her poetry books distil this experience - two books for children, one for teenagers and three for adults. For information & to buy, go to her website: www.audreycoatesworth.com Her book 'Growing Up' is showcased on bizymoms.com bookshelf. To read about and buy her novel 'Beyond Mercy' - go to www.buybeyondmercybook.com